Provider Enrollment Quality Analyst

Job Summary

Supporting provider enrollment and revalidation operations, the remote Provider Enrollment Quality Analyst will ensure the accuracy, quality, and compliance of provider enrollment transactions and documentation while collaborating with operational teams to identify trends and improve processes.

Key responsibilities

• Conduct quality reviews and audits of provider enrollment applications and supporting documentation to ensure compliance with healthcare guidelines
• Monitor operational quality standards and identify deficiencies, root causes, and opportunities for process improvement
• Prepare reports on quality findings and collaborate with leadership to recommend corrective actions and training opportunities

Required qualifications

• High school diploma or GED required; associate degree or additional post-secondary education in healthcare administration or related field preferred
• 2+ years of experience in provider enrollment, healthcare operations, or quality assurance within a healthcare environment
• Experience performing quality reviews or audits in a healthcare operations setting preferred
• Working knowledge of Medicaid, Medicare, and healthcare compliance standards preferred
• Strong analytical and organizational skills, with proficiency in Microsoft Office, including Excel